scholarly journals Acute pain in cats: Recent advances in clinical assessment

2018 ◽  
Vol 21 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Paulo V Steagall ◽  
Beatriz P Monteiro
Keyword(s):  
Acute Pain ◽  
Pain Assessment ◽  
Pain Scale ◽  
Treatment Standards ◽  
Future Directions ◽  
Recent Advances ◽  
Pain Scales ◽  
Species Specific ◽  
Pain Recognition ◽  
Development And Validation

Practical relevance: Pain assessment has gained much attention in recent years as a means of improving pain management and treatment standards. It has become an elemental part of feline practice with ultimate benefit to feline health and welfare. Currently pain assessment involves mostly the investigation of sensory-discriminative (intensity, location and duration) and affective-motivational (emotional) domains of pain. Specific behaviors associated with acute pain have been identified and constitute the basis for its assessment in cats. Recent advances: The publication of pain scales with reported validation – the UNESP-Botucatu multidimensional composite pain scale and the Glasgow feline composite measure pain scale – and species-specific studies have advanced our knowledge on the subject. Facial expressions have also been shown to be different between painful and non-painful cats, and very recently the Feline Grimace Scale has been validated as a tool for acute pain assessment. Clinical challenges: Despite recent advances, several challenges still exist. For instance, the effects of disease and sedation on pain scoring/ assessment are unknown. Also, specific painful conditions (eg, dental pain) have not been systematically investigated. The development and validation of instruments for pain assessment by cat owners is warranted, as these tools are currently lacking. Aims: This article reviews the use, advantages, disadvantages and limitations of the two validated pain scales, and presents a practical, stepwise approach to feline pain recognition and assessment using a dynamic and interactive process. The authors also offer perspectives regarding current challenges and future directions.

scholarly journals Monitoring Acute Pain in Donkeys with the Equine Utrecht University Scale for Donkeys Composite Pain Assessment (EQUUS-DONKEY-COMPASS) and the Equine Utrecht University Scale for Donkey Facial Assessment of Pain (EQUUS-DONKEY-FAP)

Animals ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 354 ◽  
Author(s):  
Machteld C. van Dierendonck ◽  
Faith A. Burden ◽  
Karen Rickards ◽  
Johannes P.A.M. van Loon
Keyword(s):  
Postoperative Pain ◽  
Acute Pain ◽  
Pain Assessment ◽  
Pain Scale ◽  
Follow Up Study ◽  
Observer Reliability ◽  
Pain Scales ◽  
Different Types ◽  
Good For

Objective pain assessment in donkeys is of vital importance for improving welfare in a species that is considered stoic. This study presents the construction and testing of two pain scales, the Equine Utrecht University Scale for Donkey Composite Pain Assessment (EQUUS-DONKEY-COMPASS) and the Equine Utrecht University Scale for Donkey Facial Assessment of Pain (EQUUS-DONKEY-FAP), in donkeys with acute pain. A cohort follow-up study using 264 adult donkeys (n = 12 acute colic, n = 25 acute orthopaedic pain, n = 18 acute head-related pain, n = 24 postoperative pain, and n = 185 controls) was performed. Both pain scales showed differences between donkeys with different types of pain and their control animals (p < 0.001). The EQUUS-DONKEY-COMPASS and EQUUS-DONKEY-FAP showed high inter-observer reliability (Cronbach’s alpha = 0.97 and 0.94, respectively, both p < 0.001). Sensitivity of the EQUUS-DONKEY-COMPASS was good for colic and orthopaedic pain (83% and 88%, respectively), but poor for head-related and postoperative pain (17% and 21%, respectively). Sensitivity of the EQUUS-DONKEY-FAP was good for colic and head-related pain (75% and 78%, respectively), but moderate for orthopaedic and postoperative pain (40% and 50%, respectively). Specificity was good for all types of pain with both scales (91%–99%). Different types of acute pain in donkeys can be validly assessed by either a composite or a facial expression-based pain scale.

scholarly journals Objective Assessment of Acute Pain in Foals Using a Facial Expression-Based Pain Scale

Animals ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 1610
Author(s):  
Johannes van Loon ◽  
Nicole Verhaar ◽  
Els van den Berg ◽  
Sarah Ross ◽  
Janny de Grauw
Keyword(s):  
Facial Expression ◽  
Acute Pain ◽  
Pain Assessment ◽  
Objective Assessment ◽  
Diagnostic Procedures ◽  
Pain Scale ◽  
Video Recordings ◽  
Pain Scores ◽  
Flunixin Meglumine ◽  
Pain Scales

Pain assessment is very important for monitoring welfare and quality of life in horses. To date, no studies have described pain scales for objective assessment of pain in foals. Studies in other species have shown that facial expression can be used in neonatal animals for objective assessment of acute pain. The aim of the current study was to adapt a facial expression-based pain scale for assessment of acute pain in mature horses for valid pain assessment in foals. The scale was applied to fifty-nine foals (20 patients and 39 healthy controls); animals were assessed from video recordings (30–60 s) by 3 observers, who were blinded for the condition of the animals. Patients were diagnosed with acute health problems by means of clinical examination and additional diagnostic procedures. EQUUS-FAP FOAL (Equine Utrecht University Scale for Facial Assessment of Pain in Foals) showed good inter- and intra-observer reliability (Cronbach’s alpha = 0.95 and 0.98, p < 0.001). Patients had significantly higher pain scores compared to controls (p < 0.001) and the pain scores decreased after treatment with NSAIDs (meloxicam or flunixin meglumine IV) (p < 0.05). Our results indicate that a facial expression-based pain scale could be useful for the assessment of acute pain in foals. Further studies are needed to validate this pain scale.

Rasch development and validation of a new faces scale for measuring pain, and its comparison with a gold standard: the Balparda–Herrera Pain Scale

2021 ◽  
Author(s):  
Kepa Balparda ◽  
Tatiana Herrera-Chalarca ◽  
Melissa Cano-Bustamante ◽  
Tatiana Gómez-González ◽  
María Alejandra Nicholls-Molina
Keyword(s):  
Gold Standard ◽  
Statistical Tests ◽  
Adult Population ◽  
Pain Scale ◽  
Rasch Modeling ◽  
Final Version ◽  
Pain Scales ◽  
Development And Validation

Aim: Faces pain scales are widely used to measure pain. So far, no faces pain scale has ever been constructed by Rasch modeling. Hence the authors aimed to construct a new scale by this method. Methods: Rasch modeling was used to provide an initial calibration and development of the ‘Balparda–Herrera Pain Scale’ (BHPS) and this scale was compared with the existing Faces Pain Scale – Revised. The scale was later refined. Results: Both the existing scale and the initial version of the BHPS required category collapsing. Statistical tests demonstrated an excellent concordance between both scales. The final version of the BHPS was found to behave excellently and to be capable of adequately measuring pain. Conclusion: The BHPS provides an excellent instrument for measuring pain in the adult population.

scholarly journals  Pain in domestic animals and how to assess it: a review

2012 ◽  
Vol 57 (No. 4) ◽  
pp. 185-192 ◽  
Author(s):  
L. Landa
Keyword(s):  
Pain Management ◽  
Animal Welfare ◽  
Pain Assessment ◽  
Domestic Animals ◽  
Current Review ◽  
Adult Humans ◽  
Clinical Responses ◽  
General Signs ◽  
Species Specific ◽  
Pain Recognition

&nbsp;In recent years more attention has been paid to the issue of pain in animals, particularly in association with increasing awareness of animal welfare. It is therefore necessary for veterinarians to be able recognise unambiguously whether an animal suffers from pain. Adult humans suffering from pain can more or less characterise their painful experiences, including the site and intensity of the pain. However, pain in animals is in some aspects more complex and it can be rather difficult to evaluate the seriousness and impact of painful events. Therefore, in animals we have to recognise the signs of pain according to indirect markers which involve behavioural, physiological and finally clinical responses. Moreover, in particular the behavioural changes associated with pain can be along with the general signs also species-specific, and hardly recognisable (and for an inexperienced observer seemingly unimportant) which makes pain assessment even more complicated. Therefore, the current review formulates definitions of pain, its classification and is focused on methods that may facilitate pain recognition in animals, which is crucial for an effective pain assessment and consequent effective pain management. The review combines recent knowledge with well proven facts concerning pain and furthermore also highlights the author&rsquo;s own research on pain assessment. &nbsp; &nbsp;

scholarly journals Facial expressions of pain in cats: the development and validation of a Feline Grimace Scale

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Marina C. Evangelista ◽  
Ryota Watanabe ◽  
Vivian S. Y. Leung ◽  
Beatriz P. Monteiro ◽  
Elizabeth O’Toole ◽  
...  
Keyword(s):  
Acute Pain ◽  
Pain Assessment ◽  
Rater Reliability ◽  
Analgesic Treatment ◽  
Naturally Occurring ◽  
Total Pain ◽  
Excellent Internal Consistency ◽  
Development And Validation ◽  
Validated Instrument ◽  
Control Study

AbstractGrimace scales have been used for pain assessment in different species. This study aimed to develop and validate the Feline Grimace Scale (FGS) to detect naturally-occurring acute pain. Thirty-five client-owned and twenty control cats were video-recorded undisturbed in their cages in a prospective, case-control study. Painful cats received analgesic treatment and videos were repeated one hour later. Five action units (AU) were identified: ear position, orbital tightening, muzzle tension, whiskers change and head position. Four observers independently scored (0–2 for each AU) 110 images of control and painful cats. The FGS scores were higher in painful than in control cats; a very strong correlation with another validated instrument for pain assessment in cats was observed (rho = 0.86, p < 0.001) as well as good overall inter-rater reliability [ICC = 0.89 (95% CI: 0.85–0.92)], excellent intra-rater reliability (ICC > 0.91), and excellent internal consistency (Cronbach’s alpha = 0.89). The FGS detected response to analgesic treatment (scores after analgesia were lower than before) and a cut-off score was determined (total pain score > 0.39 out of 1.0). The FGS is a valid and reliable tool for acute pain assessment in cats.

In pursuit of pain: recent advances and future directions in pain assessment in the ICU

2014 ◽  
Vol 40 (7) ◽  
pp. 1009-1014 ◽  
Author(s):  
Céline Gélinas ◽  
Gerald Chanques ◽  
Kathleen Puntillo
Keyword(s):  
Pain Assessment ◽  
Future Directions ◽  
Recent Advances

Evaluation of targeted bupivacaine for reducing acute postoperative pain in cats undergoing routine ovariohysterectomy

2019 ◽  
Vol 22 (2) ◽  
pp. 91-99 ◽  
Author(s):  
James Mack Fudge ◽  
Bernie Page ◽  
Amy Mackrell ◽  
Inhyung Lee
Keyword(s):  
Postoperative Pain ◽  
Acute Pain ◽  
Rating Scale ◽  
High Volume ◽  
Pain Scale ◽  
Placebo Control ◽  
Controlled Clinical Trial ◽  
Colorado State University ◽  
Pain Scores ◽  
Pain Scales

Objectives This study sought to determine if bupivacaine targeted at specific, potentially painful sites could enhance postoperative analgesia in routine feline ovariohysterectomies. A secondary objective was to assess the utility of multiple acute pain scales for cats in a high-volume surgery setting. Methods Two hundred and twelve cats were included in a prospective, randomized, double-blinded, placebo-controlled clinical trial. Anesthesia included buprenorphine, ketamine, dexmedetomidine and isoflurane. A ventral midline ovariohysterectomy was performed and cats were administered bupivacaine (2 mg/kg), placebo control (0.9% saline) or sham control (observation only) intraoperatively at the ovarian suspensory ligaments and vessels, uterine body and incisional subcutaneous tissues. Two pain scales were used to assess cats postoperatively. Initially, a multidimensional composite pain scale (MCPS) and a 0–10 numeric pain rating scale (NRS) were used. Subsequently, the MCPS was replaced with a modified Colorado State University Feline Acute Pain Scale (mCSU). Pain scores for the test groups were compared using a one-way ANOVA and a Holm–Bonferroni post hoc analysis when a difference was found ( P <0.05). Results Pain for the bupivacaine group was lower than the control groups at 1 h post-recovery and discharge, attaining significance with higher body weights. The P values were 0.008 and 0.004 for 1 h post-recovery and discharge, respectively. Pain scores between evaluators for the MCPS and NRS correlated poorly with r values for 1 h post-recovery and discharge of −0.08 and 0.22, respectively. Additionally, the MCPS proved difficult to use and time consuming, especially for feral and fractious patients, and was replaced with the mCSU. Conclusions and relevance Targeted bupivacaine reduced early postoperative pain scores following routine feline ovariohysterectomies. The technique used was simple, requiring just over a minute to perform at minimal additional cost. The MCPS was not ideal for use in a high-volume spay setting.

Chronic pain in cats: Recent advances in clinical assessment

2019 ◽  
Vol 21 (7) ◽  
pp. 601-614 ◽  
Author(s):  
Beatriz P Monteiro ◽  
Paulo V Steagall
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Assessment ◽  
Negative Impact ◽  
Clinical Signs ◽  
Response To Therapy ◽  
Pain Mechanisms ◽  
Recent Advances ◽  
Pain Scales

Practical relevance: Chronic pain is a feline health and welfare issue. It has a negative impact on quality of life and impairs the owner–cat bond. Chronic pain can exist by itself or may be associated with disease and/or injury, including osteoarthritis (OA), cancer, and oral and periodontal disease, among others. Clinical challenges: Chronic pain assessment is a fundamental part of feline practice, but can be challenging due to differences in pain mechanisms underlying different conditions, and the cat’s natural behavior. It relies mostly on owner-assessed behavioral changes and time-consuming veterinary consultations. Beyond OA – for which disease-specific clinical signs have been described – little is known regarding other feline conditions that produce chronic pain. Recent advances: Knowledge of the subject has, however, greatly improved in the past few years, informed by study of the mechanisms of pain in cats with OA and the development of pain scales that can be used by owners or veterinarians. Pain scales may facilitate the diagnosis and follow-up evaluation of chronic painful conditions, providing a basis for therapeutic decision-making. Assessment of quality of life is also recommended in cats with chronic pain, and its improvement can be used as a positive outcome in response to therapy. Aims: This article reviews recent advances and presents the challenges and some future perspectives on clinical chronic pain assessment. The most common feline chronic conditions associated with pain are also described.

Comparison of Self-Reported and Behavioral Pain Assessment Tools in Critically Ill Patients

2018 ◽  
Vol 35 (5) ◽  
pp. 453-460 ◽  
Author(s):  
Rima H. Bouajram ◽  
Christian M. Sebat ◽  
Dawn Love ◽  
Erin L. Louie ◽  
Machelle D. Wilson ◽  
...  
Keyword(s):  
Critically Ill ◽  
Pain Assessment ◽  
Critically Ill Patients ◽  
Strong Correlation ◽  
Rating Scale ◽  
Assessment Method ◽  
Pain Scale ◽  
Assessment Tools ◽  
Pain Scales ◽  
Behavioral Pain Scale

Background:Self-reported and behavioral pain assessment scales are often used interchangeably in critically ill patients due to fluctuations in mental status. The correlation between scales is not well elucidated. The purpose of this study was to describe the correlation between self-reported and behavioral pain scores in critically ill patients.Methods:Pain was assessed using behavioral and self-reported pain assessment tools. Behavioral pain tools included Critical Care Pain Observation Tool (CPOT) and Behavioral Pain Scale (BPS). Self-reported pain tools included Numeric Rating Scale (NRS) and Wong-Baker Faces Pain Scales. Delirium was assessed using the confusion assessment method for the intensive care unit. Patient preference regarding pain assessment method was queried. Correlation between scores was evaluated.Results:A total of 115 patients were included: 67 patients were nondelirious and 48 patients were delirious. The overall correlation between self-reported (NRS) and behavioral (CPOT) pain scales was poor (0.30, P = .018). In patients without delirium, a strong correlation was found between the 2 behavioral pain scales (0.94, P < .0001) and 2 self-reported pain scales (0.77, P < .0001). Self-reported pain scale (NRS) and behavioral pain scale (CPOT) were poorly correlated with each other (0.28, P = .021). In patients with delirium, there was a strong correlation between behavioral pain scales (0.86, P < .0001) and a moderate correlation between self-reported pain scales (0.69, P < .0001). There was no apparent correlation between self-reported (NRS) and behavioral pain scales (CPOT) in patients with delirium (0.23, P = .12). Most participants preferred self-reported pain assessment.Conclusion:Self-reported pain scales and behavioral pain scales cannot be used interchangeably. Current validated behavioral pain scales may not accurately reflect self-reported pain in critically ill patients.

scholarly journals The Quality of Pain Treatment in Community-Dwelling Persons with Dementia

2015 ◽  
Vol 5 (3) ◽  
pp. 470-481 ◽  
Author(s):  
Jiwen Li ◽  
A. Lynn Snow ◽  
Nancy Wilson ◽  
Melinda A. Stanley ◽  
Robert O. Morgan ◽  
...  
Keyword(s):  
Pain Assessment ◽  
Medical Records ◽  
Pain Treatment ◽  
Pain Scale ◽  
Veterans Affairs ◽  
Community Dwelling ◽  
Pain Scales ◽  
Pain Care

Background/Aims: Despite pervasive and debilitating pain among elders, it is underassessed and undertreated; and cognitive impairment can add challenges. We assessed the quality of pain care for community-dwelling elderly patients with dementia. Methods: We phone interviewed 203 Veterans Affairs primary care outpatients with dementia and pain and reviewed medical records to score 15 quality indicators of pain assessment and management. Results: Pain assessment was documented for 98%, and a standard pain scale was used for 94%. Modified pain scales were rarely used. Though 70% self-reported pain of ‘quite bad' or worse, charts documented no pain in 64%. When pain was identified, treatment was offered to 80%; but only 59% had a follow-up assessment within 6 months. Nonpharmacological interventions were underused. Conclusion: Community-dwelling elders with dementia are underdiagnosed and undertreated for pain.

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